Holsan Behavioral Health | |
1631 Midtown Pl Ste 104-110 Raleigh NC 27609-1300 | |
(336) 355-2142 | |
Not Available |
Full Name | Holsan Behavioral Health |
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Speciality | Clinic/Center |
Location | 1631 Midtown Pl Ste 104-110, Raleigh, North Carolina |
Authorized Official Name and Position | Adrienne Holloway (OWNER) |
Authorized Official Contact | 3363552142 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Holsan Behavioral Health 1631 Midtown Pl Ste 104-110 Raleigh NC 27609-1300 Ph: (336) 355-2142 | Holsan Behavioral Health 1631 Midtown Pl Ste 104-110 Raleigh NC 27609-1300 Ph: (336) 355-2142 |
NPI Number | 1629848619 |
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Provider Enumeration Date | 01/02/2024 |
Last Update Date | 01/02/2024 |
Certification Date | 01/02/2024 |
Medicare PECOS PAC ID | 2466895644 |
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Medicare Enrollment ID | O20240205001654 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629848619 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Tenishia Kim Santiago |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497254932 PECOS PAC ID: 7113277369 Enrollment ID: I20240205001817 |
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